Nomination Form

This form does NOT submit your Nomination to anyone. And it does NOT enroll you in a Course Session.

This Nomination Form is offered as a convenience. After you fill it out, you can save it as a Word or 'RTF' document.

After you save the document, it is up to you to understand and follow the correct Nomination procedure for your Course, Area and Agency. Please read the Nomination Information page.

If you have questions about which Nomination procedure to follow, contact your Training Officer.

Remember! Filling out this form DOES NOT submit your nomination. Click the 'Help' button on the right for more information.

Fields with a red border and red asteriskare required.

Course &SessionInformation

Course Code & Name:

S481 - Incident Business Advisor

Start & End Dates:

10-10-2018 to 10-12-2018

Location:

Albuquerque, NM 87109

IQCS Session Number:

18

Tuition:

$

CoordinatorInformation

Coordinator Name:

Glenda Womack

Coordinator Email:

grwomack@fs.fed.us

Coordinator Phone:

575-313-2031

Coordinator Fax:

NomineeInformation

Nominee IQCS Emplid:

Optional. All Nominees in IQCS must provide their IQCS Emplid number. No number is required for those Nominees who are not in IQCS.

Nominee Name:

Required. First MiddleInitial Last

Nominee Title:

Optional. Nominee Job Title

Nominee Email:

Optional. Please provide a valid email address.

Training Officer Name:

Optional. Training Officer full name

Training Officer Email:

Optional. Training Officer email address

Training Officer Phone:

Optional. Training Officer phone number

Nominee Agency:

Required. Name of agency where Nominee is employed

Nominee Home Unit:

Required. Name of Nominee's Home Unit

Home Unit Street:

Required. Home Unit Address

Home Unit City:

Required. Home Unit City

Home Unit State:

Required. Home Unit State

Home Unit Zip Code:

Required. Home Unit Zip Code. If address is outside the USA, provide country information in Zip Code field.

Home Unit Phone:

Required. Home Unit Phone. Format 555-555-5555

Home Unit Fax:

Optional. Home Unit Fax. Format 555-555-5555

It is important that the Coordinator is able to contact the Nominee.
If Nominee cannot be contacted at Home Unit information above,
click "Nominee Alternative Address & Phone Information" link below and provide the information

Contractor, states, governments engaged in fire suppression and protection of public lands. This training, payment and collection is duly authorized under the Intergovernmental Cooperation Act of 1968 as amended by the act of September 13, 1982 (P.L.97-258), Section 6505. The NWCG Interagency Training Nomination constitutes written request and it is understood the bill for the training will consist of tuition plus all other identifiable costs as provided by law. Authorizing signature is also certifying services requested cannot be procured reasonably and expeditiously through ordinary business channels and funds are available. Provider's signature certifies the agency is offering similar services for its own use.

Complete Charge Code:

Provide Charge Code. Include required fiscal references.

Agreement Number:

OtherFederalAgencyInformation

Other Federal Agency:

This training, payment, and collection is duly authorized under Section 601 of the Economy Act of June 30, 1932 (31 USC 1535) as amended. The NWCG Interagency Training Nomination constitutes the required written request and it is understood the bill for the training will consist of tuition plus all other identifiable costs as provided by law. Authorizing signatures is also certifying servies requested are in the best interest of the United States; cannot be procured by contract as conveniently or cheaply from a commercial source and appropriate funds are available for this purpose. Provider's signature certifies the agency is offering similar services for its own use.

Complete Charge Code:

Include agency location

Agreement Number:

SameAgencyInformation

Same Agency Provider:

The NWCG Interagency Training Nomination constitutes agreement to pay charges as outlined in nomination materials. Authorizing signature certifies funds are available for this purpose.

Complete Charge Code:

Provide Charge Code. Include Override.

Agreement Number:

BillingInformation

Billing Name:

Optional. Provide Billing Name and Address if different than Sponsor or Agency Name and Address.

Billing Address:

Billing City:

Billing State:

Billing Zip Code:

If address is outside the USA, provide country information in Zip Code field.

Sign &ReviewNominationForm

Security:

Type in the 4 numbers in the Security image. If you cannot read the Security image, click the image to refresh it.